PREVISOR AI
A recovery going wrong, a mind starting to slip, a condition quietly worsening. The signs show up in daily life months early. Your doctor sees barely an hour of that life a year.
Pepper closes that gap.
August 2026 · CONFIDENTIAL
01
More chronic illness than ever. Fewer physicians than ever. And the warning signs live where physicians struggle to reach: daily life.
Chronic illness is exploding - 3 in 4 American adults live with a chronic condition. It consumes 90% of America's $4.9 trillion healthcare bill, mostly paid after the crisis.
Too few physicians - 15,000 primary care physicians short today, heading for 70,000 by 2038. 16% of family medicine training places went unfilled this year.
Appointments carry everything - Fifteen minutes, a few times a year, asked to hold a whole life.
The ER absorbs the fallout - Warning signs visible for months get treated for the first time in the most expensive room in medicine.
Even with twice the doctors, most signs would stay invisible because the system was not designed to see a person's life.
02
Margaret
78
“I’m absolutely fine”
On the early edge of cognitive decline, and masking it well.
Priya
32
Exhausted by her own data
A cluster of symptoms building toward diagnosis, with no one to connect them.
James
47
Invisible by choice
No one knows he is on his way to a stroke.
“
A physician sees each person they treat for a total of roughly one hour a year.* We all know that is not enough.
*Based on published primary care utilisation research. Range across studies: 60 to 90 minutes per year.
03
Three conditions are converging at once.
Ambient AI is trusted, in the clinic and the home
62% US hospitals adopted ambient clinical AI by 2025. The between-visits problem is not solved.
Reimbursement already exists
Pepper sits inside existing Medicare RTM codes, CPT 98975–98981. No new category needs to be created for Pepper to be paid.
Physician shortage, rising demand
Every appointment must do more with less time. A pre-visit brief is a force multiplier for an overwhelmed system.
Accelerators
Concierge and DPC accelerating · Investor appetite is real · Demographic certainty
Sources: MarketsandMarkets RPM 2025 · Emory study in AJMC, January 2026 · Grand View Research DPC 2024 · US Census Bureau 2024 · Abridge Series E 2026 · CMS CPT Fee Schedule 2025
04
From conversation to clinical parameter
1
Conversation with Pepper
"I stood up too quick again and had to hold onto the counter."
◆ Ordinary language
2
What Pepper records
Light-headedness on standing. Fourth time in three weeks, after two months with none. The person's own words kept alongside.
Structured observation
3
What the physician receives
Pepper reports what it observed. It does not diagnose or recommend.
Clinical decision
Only at the intersection
Actionable intelligence that physicians do not have today
Social
Connection & withdrawal
Cognitive
Alertness & memory
Purpose
Motivation & meaning
Physiological
Sleep & movement
05
Physician-prescribed
Voice-first on a Mac Mini with a companion app. Prescribed with clinical authority, paid through existing CPT codes.
What the person experiences
Ordinary conversation across ordinary days. Companionship is what the person feels. No forms, no wearables, nothing to log.
What the physician receives
The Pre-Visit Brief before every appointment. A three-minute read showing what a fifteen-minute visit cannot see.
Where the value lives
In the months before a diagnosis becomes necessary, while there is still time to change the trajectory.
06
Glenn
Subclinical pattern detected
Lifelong runner. Presenting as healthy.
Respiratory and sleep-disruption markers fire beneath a healthy presentation. Pepper probes rather than reassures.
Pepper says
“Are you feeling burnt out, or is there something specific driving the change?”
Tara
“Facade” detection
Three cancelled physicals. Deflecting headaches as motherhood.
Accumulating avoidance pattern fires. All three facade indicators active simultaneously.
Pepper says
“We know it’s not just that, Tara… you’re experiencing symptoms that are impacting your daily life.”
Walter
Remembers across weeks and months
Blood pressure monitoring. Memory and recall.
Doctor’s name, BP reading and medication held across an off-topic digression about a bird feeder. Recalled correctly ten turns later.
Pepper says
“Dr. Patterson said 130 over 85, she mentioned watching the sodium.”
Seven personas tested
Clinical signal extracted automatically
Zero false positives on facade detection
Full demo available on request
07
Person
A continuous reflection of their own patterns builds awareness and motivation. The longer Pepper runs, the more useful it becomes.
Physician
Each appointment is informed by a fuller picture and clinical judgement improves as the data deepens.
Pepper
Family
Confidence that the people they care about are seen and understood between visits.
Researchers
A record of how someone actually lives, built over months and years. valuable for understanding the earliest markers of cognitive decline, depression and chronic disease.
US RTM market by 2033
$1.68B
From $439M today, growing 18.7% a year. The Medicare billing category Pepper sits inside, within a $29B US remote monitoring sector.
No competitor sits inside daily life with a physician in the loop.
Research platforms capture behavioural signal in time-limited trials, not as a continuous layer of clinical intelligence in routine care. Source: Sources: Grand View Research 2026 · MarketsandMarkets 2025.
08
Pepper sits inside existing CPT reimbursement codes. The physician earns from prescribing it.
Personal subscription. Three ways to pay.
Insurance reimbursement
Billed through existing Medicare RTM codes (CPT 98975–98981). The majority is insurance-reimbursed, with a modest monthly copay. Opens the market well beyond cash-pay.
HSA-qualified — paid with pre-tax dollars.
Cash-pay — the person pays the practice directly.
Split three ways — $50 each
$50
Physician
Net income per person. No additional clinical time. Aligned incentive to prescribe. 20 people = $1,000/month per physician.
$50
Previsor
$50
Hardware & Ops
Mac Mini (~$800) amortised over 36 months. Care centre, three-day replacement, HIPAA-compliant infrastructure. Fixed cost. Spreads across the installed base.
>50% gross margin
~$0 customer acquisition cost
~$0 per-device cloud compute
CPT codes already exist
09
Crowded with point solutions.
Empty at the intersection.
Daily relationship
Clinical NLP
In-home capture
Physician in loop
Preclinical insights
Cash-pay channel
ElliQ
$85M raised
Yes
No
Yes
No
No
Yes
General-purpose LLMs
ChatGPT · Claude · Gemini
No
No
No
No
No
No
Smart health devices
Hero Health et al.
No
No
Yes
No
Limited
Yes
RPM Devices
Vitals only
No
No
Limited
Limited
Limited
No
Wearables
Biometrics only
No
No
Limited
No
Limited
No
Ambient scribes
Abridge, Nuance
No
Yes
No
Yes
No
No
Pepper
Physician-prescribed
Yes
Yes
Yes
Yes
Yes
Yes
ElliQ reduces loneliness. Scribes live in the exam room. Chatbots answer when asked. None of them sit where Pepper sits.
10
90-day pilot, Winter 2026. 20 patients per practice. Pilot partners in negotiation across primary care and functional medicine practices in Central New York. Full demo available on request.
CONVENTIONAL
2 Practices
Pepper inside the most time-pressured clinical environment. Anchors institutional credibility
FUNCTIONAL MEDICINE
1 Practice
Cash-pay traction with people who already pay out of pocket. The likeliest source of an early paid extension.
Four proof criteria
1
Clinical signal validity
2
Relational integrity
3
Physician utility
4
Financial viability
11
Clinical practice · Cross-cultural psychology · Relational AI design · Healthcare commercialisation · Infrastructure engineering
Dana Hoffer
Exec Chair & Chief Technical Officer
Built ventures from network infrastructure to AI-powered products. Engineering depth and entrepreneurial execution.
Ananya Rao-Middleton
President & Chief Relational Intelligence Officer
Leads Previsor. Founder of the Institute of Relational AI and a Churchill Fellow, bridging anthropology, behavioural science and AI safety. Owns the relational and clinical-translation layer at the core of Pepper.
David Wetherhold, MD
Chief Clinical Officer
Practising internal medicine physician and CMIO, Scripps Health. 30 years of practice with ambient-AI implementation.
Nandini Nayak, PhD
Clinical Architect
Presidential Innovation Fellow. Clinical and cognitive psychology. Designed Pepper’s wellbeing framework.
Jane Hoffer
Head of Advisory
Nine years on the Board of Trustees, Einstein Healthcare Network, chairing the IT committee through a $150M electronic medical records investment. CEO/COO/founder across startups and public exits. Unlocked $90M+ and scaled revenue 10× through global partnerships.
Lori Sussle Bonanni
Head of Market Development & Comms
Manages our Marketing and Comms effort, ensuring our messaging reaches the right audiences effectively.
Clinical council in formation, led by David Wetherhold MD, drawing on physicians across primary care, gerontology, cardiology and surgery.
12
Do you believe in the problem?
The signals that precede a health crisis are present, continuous and invisible to the current clinical system.
Do you believe in the product direction?
Physician-prescribed. Relational and behavioural signal captured continuously, translated into a structured clinical brief, building a data asset that compounds in value.
Do you believe in the first steps?
A 90-day pilot across three practices with four proof criteria set in advance, demoing to a health system executive team in September. This round funds the pilot and the evidence that opens Series A from strength.
Investment ask
Team
~40%
~$1M · Founder runway through pilot. One clinical lead hire.
Engineering
~25%
~$600K · Layer 1 conversational engine. Pre-Visit Brief generator. Edge orchestration.
Pilot & Evidence
~30%
~$750K · Hardware. Physician compensation. Regulatory, clinical clearance.
Operations
~5%
~$125K · Insurance, fractional CFO, legal retainer, 10% contingency.
Validated clinical signal
Foundational data asset
Series A from strength